401 research outputs found
Determinants of farmer adoption of organic production methods in the fresh-market produce sector in California: A logistic regression analysis
This research uses binomial and multinomial logistic regression models to identify the factors that influence farmers adoption of organic technology. Using a sample of 175 farmers growing fresh-market produce in three California counties, the first model examines farmers choice between conventional-only and organic-only production. The second model compares conventional-only and "dual-method" (combined conventional and organic) production, while the third model employs all three choices in a multinomial model. These results, which indicate that gross sales, direct marketing, number of crops and acres, farmer age, and computer usage are significant determinants, have implications on policies that regulate the organic foods sector.Production Economics,
Implementing telephone triage in general practice: a process evaluation of a cluster randomised controlled trial
Background: Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. However, limited evidence exists of the challenges GP practices face in implementing telephone triage. We conducted a qualitative process evaluation alongside a UK-based cluster randomised trial (ESTEEM) which compared the impact of GP-led and nurse-led telephone triage with usual care on primary care workload, cost, patient experience, and safety for patients requesting a same-day GP consultation. The aim of the process study was to provide insights into the observed effects of the ESTEEM trial from the perspectives of staff and patients, and to specify the circumstances under which triage is likely to be successfully implemented. Here we report perspectives of staff. Methods: The intervention comprised implementation of either GP-led or nurse-led telephone triage for a period of 2-3 months. A qualitative evaluation was conducted using staff interviews recruited from eight general practices (4 GP triage, 4 Nurse triage) in the UK, implementing triage as part of the ESTEEM trial. Qualitative interviews were undertaken with 44 staff members in GP triage and nurse triage practices (16 GPs, 8 nurses, 7 practice managers, 13 administrative staff). Results: Staff reported diverse experiences and perceptions regarding the implementation of telephone triage, its effects on workload, and on the benefits of triage. Such diversity were explained by the different ways triage was organised, the staffing models used to support triage, how the introduction of triage was communicated across practice staff, and by how staff roles were reconfigured as a result of implementing triage. Conclusion: The findings from the process evaluation offer insight into the range of ways GP practices participating in ESTEEM implemented telephone triage, and the circumstances under which telephone triage can be successfully implemented beyond the context of a clinical trial. Staff experiences and perceptions of telephone triage are shaped by the way practices communicate with staff, prepare for and sustain the changes required to implement triage effectively, as well as by existing practice culture, and staff and patient behaviour arising in response to the changes made. Trial registration: Current Controlled Trials ISRCTN20687662. Registered 28 May 2009
The immunogenicity of a viral cytotoxic T cell epitope is controlled by its MHC-bound conformation
Thousands of potentially antigenic peptides are encoded by an infecting pathogen; however, only a small proportion induce measurable CD8+ T cell responses. To investigate the factors that control peptide immunogenicity, we have examined the cytotoxic T lymphocyte (CTL) response to a previously undefined epitope (77APQPAPENAY86) from the BZLF1 protein of Epstein-Barr virus (EBV). This peptide binds well to two human histocompatibility leukocyte antigen (HLA) allotypes, HLA-B*3501 and HLA-B*3508, which differ by a single amino acid at position 156 (156Leucine vs. 156Arginine, respectively). Surprisingly, only individuals expressing HLA-B*3508 show evidence of a CTL response to the 77APQPAPENAY86 epitope even though EBV-infected cells expressing HLA-B*3501 process and present similar amounts of peptide for CTL recognition, suggesting that factors other than peptide presentation levels are influencing immunogenicity. Functional and structural analysis revealed marked conformational differences in the peptide, when bound to each HLA-B35 allotype, that are dictated by the polymorphic HLA residue 156 and that directly affected T cell receptor recognition. These data indicate that the immunogenicity of an antigenic peptide is influenced not only by how well the peptide binds to major histocompatibility complex (MHC) molecules but also by its bound conformation. It also illustrates a novel mechanism through which MHC polymorphism can further diversify the immune response to infecting pathogens
Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): A cluster-randomised controlled trial and cost-consequence analysis
Telephone triage is increasingly used to manage workload in primary care; however, supporting evidence for this approach is scarce. We aimed to assess the effectiveness and cost consequences of general practitioner-(GP)-led and nurse-led telephone triage compared with usual care for patients seeking same-day consultations in primary care
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An integrated clinical program and crowdsourcing strategy for genomic sequencing and Mendelian disease gene discovery.
Despite major progress in defining the genetic basis of Mendelian disorders, the molecular etiology of many cases remains unknown. Patients with these undiagnosed disorders often have complex presentations and require treatment by multiple health care specialists. Here, we describe an integrated clinical diagnostic and research program using whole-exome and whole-genome sequencing (WES/WGS) for Mendelian disease gene discovery. This program employs specific case ascertainment parameters, a WES/WGS computational analysis pipeline that is optimized for Mendelian disease gene discovery with variant callers tuned to specific inheritance modes, an interdisciplinary crowdsourcing strategy for genomic sequence analysis, matchmaking for additional cases, and integration of the findings regarding gene causality with the clinical management plan. The interdisciplinary gene discovery team includes clinical, computational, and experimental biomedical specialists who interact to identify the genetic etiology of the disease, and when so warranted, to devise improved or novel treatments for affected patients. This program effectively integrates the clinical and research missions of an academic medical center and affords both diagnostic and therapeutic options for patients suffering from genetic disease. It may therefore be germane to other academic medical institutions engaged in implementing genomic medicine programs
Ecological and socioeconomic impacts of invasive alien species in island ecosystems
Minimizing the impact of invasive alien species (IAS) on islands and elsewhere requires researchers to provide cogent information on the environmental and socioeconomic consequences of IAS to the public and policy makers. Unfortunately, this information has not been readily available owing to a paucity of scientific research and the failure of the scientific community to make their findings readily available to decision makers. This review explores the vulnerability of islands to biological invasion, reports on environmental and socioeconomic impacts of IAS on islands and provides guidance and information on technical resources that can help minimize the effects of IAS in island ecosystems. This assessment is intended to provide a holistic perspective on island-IAS dynamics, enable biologists and social scientists to identify information gaps that warrant further research and serve as a primer for policy makers seeking to minimize the impact of IAS on island systems. Case studies have been selected to reflect the most scientifically-reliable information on the impacts of IAS on islands. Sufficient evidence has emerged to conclude that IAS are the most significant drivers of population declines and species extinctions in island ecosystems worldwide. Clearly, IAS can also have significant socioeconomic impacts directly (for example human health) and indirectly through their effects on ecosystem goods and services.These impacts are manifest at all ecological levels and affect the poorest, as well as richest, island nations. The measures needed to prevent and minimize the impacts of IAS on island ecosystems are generally known. However, many island nations and territories lack the scientific and technical information, infrastructure and human and financial resources necessary to adequately address the problems caused by IAS. Because every nation is an exporter and importer of goods and services, every nation is also a facilitator and victim of the invasion of alien species.Wealthy nations therefore need to help raise the capacity of island nations and territories to minimize the spread and impact of IAS
An observational study of ear-tagged calf mortality (1 to 100 days) on Irish dairy farms and associations between biosecurity practices and calf mortality on farms participating in a Johne's disease control program
Postnatal mortality among replacement stock has a detrimental effect on the social, economic, and environmental sustainability of dairy production. Calf mortality rates vary between countries and show differences in temporal trends; most, however, are characterized by high levels of between-farm variability. Explaining this variation can be difficult because herd-level information on management practices relevant to calf health is often not available. The Irish Johne's Control Programme (IJCP) contains a substantial on-farm monitoring program called the Veterinary Risk Assessment and Management Plan (VRAMP). Although this risk assessment is largely focused on factors relevant to the transmission of paratuberculosis, many of its principles are good practice biocontainment policies that are also advocated for the protection of calf health. The objectives of this study were (1) to quantify mortality in ear-tagged Irish dairy calves between 2016 and 2020 using both survival and risk approaches, (2) to determine risk factors for 100-d cumulative mortality hazard in ear-tagged Irish dairy calves between 2016 and 2020, (3) to determine whether 100-d cumulative mortality hazard was higher in ear-tagged calves within herds registered in the IJCP versus those that were not registered in the IJCP and whether there were differences between these cohorts over time, and (4) within IJCP herds, to determine whether VRAMP score or changes in VRAMP score were associated with 100-d cumulative mortality hazard. Excluding perinatal mortality, the overall 100-d cumulative mortality hazard was 4.1%. Calf mortality was consistently underestimated using risk approaches that did not account for calf censoring. Cox proportional hazards models showed that cumulative mortality hazard was greater in male calves; particularly, calves born to Jersey breed dams and those with a beef breed sire. Mortality hazard increased with increasing herd size, was highest in calves born in herds that contract-reared heifers, and lowest in those born in mixed dairy-beef enterprises. Mortality hazard decreased over time with the mortality hazard in 2020 being 0.83 times that of 2016. Mortality hazard was higher in IJCP-registered herds than nonregistered herds (hazard ratio 1.06, 95% CI 1.01–1.12), likely reflecting differences in herds that enrolled in the national program. However, we detected a significant interaction between IJCP status (enrolled vs. not enrolled) and year (hazard ratio 0.96, 95% CI 0.92–1.00), indicating that the decrease in mortality hazard between 2016 and 2020 was greater in IJCP herds versus non-IJCP herds. Finally, increasing VRAMP scores (indicating higher risk for paratuberculosis transmission) were positively associated with increased calf mortality hazard. Postnatal calf mortality rates in Irish dairy herds declined between 2016 and 2020. Our study suggests that implementation of recommended biocontainment practices to control paratuberculosis in IJCP herds was associated with a reduction in calf mortality hazard
PTF10fqs: A Luminous Red Nova in the Spiral Galaxy Messier 99
The Palomar Transient Factory (PTF) is systematically charting the optical
transient and variable sky. A primary science driver of PTF is building a
complete inventory of transients in the local Universe (distance less than 200
Mpc). Here, we report the discovery of PTF10fqs, a transient in the luminosity
"gap" between novae and supernovae. Located on a spiral arm of Messier 99, PTF
10fqs has a peak luminosity of Mr = -12.3, red color (g-r = 1.0) and is slowly
evolving (decayed by 1 mag in 68 days). It has a spectrum dominated by
intermediate-width H (930 km/s) and narrow calcium emission lines. The
explosion signature (the light curve and spectra) is overall similar to thatof
M85OT2006-1, SN2008S, and NGC300OT. The origin of these events is shrouded in
mystery and controversy (and in some cases, in dust). PTF10fqs shows some
evidence of a broad feature (around 8600A) that may suggest very large
velocities (10,000 km/s) in this explosion. Ongoing surveys can be expected to
find a few such events per year. Sensitive spectroscopy, infrared monitoring
and statistics (e.g. disk versus bulge) will eventually make it possible for
astronomers to unravel the nature of these mysterious explosions.Comment: 12 pages, 12 figures, Replaced with published versio
Decline in Estimated Glomerular Filtration Rate and Subsequent Risk of End-Stage Renal Disease and Mortality
Peer reviewedPostprin
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